Provider Demographics
NPI:1417371154
Name:AMARA PAIN & SPINE PLLC
Entity Type:Organization
Organization Name:AMARA PAIN & SPINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHVIN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:AMARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-283-1344
Mailing Address - Street 1:6429 BANNINGTON RD STE B
Mailing Address - Street 2:NONE
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-1345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6429 BANNINGTON RD STE B
Practice Address - Street 2:NONE
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1345
Practice Address - Country:US
Practice Address - Phone:646-283-1344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-01487207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty